Dr. James Swain, MD

He starts his sleeves 6 cm above the pyloris, making for a sleeve with more volume. I had stated early on I was able to eat more than other people I knew who had sleeves, and I was concerned that I was not losing very fast. But I only found out about Swain’s 6 cm technique from a competitor. Dr. Swain never told me himself — even after I voiced my concerns about slow weight loss and that I didn’t seem to have much restriction and could eat more than other sleevers I knew. Many other surgeons start at only 2-3 cm above the pyloris, making for a smaller antrum/sleeve volume. Most sleeves are made to have a volume of 150-200 cc’s. My sleeve from Dr. Swain was tested by another bariatric surgeon via EGD to be 275-300 cc’s in volume (I wanted an unbiased opinion). Not believing the results of the EGD Report by the other surgeon, Dr. Swain had me undergo an Upper GI with barium swallow too. The doctor who did that test verbally told me my Antrum looked pretty roomy. It probably… has to do with starting the sleeve 6 cm above the pyloris. I then requested to meet with Dr. Swain to discuss both reports. He was angry and defensive about the results of both reports. He said whether it is 2-3 cm or 6 cm above the pyloris makes no difference, and that VSG “is not a restrictive surgery.” Instead of admitting he makes bigger sleeves than some other surgeons, prior to my appointment with him he had combed through the past notes of my appointments with his dietitian from months ago to look for reasons to blame ME for my slow weight loss. (I have lost 62 lbs in 8 months. At one point he said that was good progress...) He said I was not following protocol because I occasionally drank coffee (no sugar) and sometimes had 1/4 C of organic short grain brown rice with my protein, and my calorie intake was more like 1,000 after my third month. However, his dietitian did not SPECIFY a calorie limit (nor does their informational binder they give all patients, I don’t think), and she was more concerned with patients paying attention to getting in enough protein. But Dr. Swain said during this appointment that I should only be consuming 700 calories at this juncture (8 months post-op). I told him I could not consume that little with this big sleeve. He said I should not expect the sleeve to do all the work. I would like my sleeve to do SOME of the work... I then emailed his dietitian asking how many calories I should be having and she said 800-1,000. I responded that Swain had just told me 700. She then modified her suggestion down to 700. Oh please! I find it odd that most doctors in general put non-weight loss surgery patients on a 1,500 calorie plan fully expecting them to lose 2.5 lbs a week, but a bariatric patient is told to do 700 and is blamed for slow weight loss because of coffee and a little organic brown rice. He also suggested I work out more. Dr. Swain knows I have Hypothyroidism, Fibromyalgia, Adrenal Fatigue and mild Depression. I re-watched the 1 hour online Seminar video that I was required to watch prior to my initial consultation last year. Both Drs. Reynoso and Swain talked about the various hormonal issues and survival mechanisms of the body that cause and maintain obesity. But it now seems that what is really believed is that their obese patients are lazy pigs, and that even though two other bariatric surgeons looked at both of my diagnostic reports and agreed my sleeve is too big, it is not Dr. Swain’s fault AT ALL. ?? Dr. Swain did not refer me out for any help from a specialist, such as an Endocrinologist. But he DID suggest I come have appointments with his (anorexic-looking and very young) dietitian once a month... The surgeon who performed the EGD said I probably would not reach my goal without a re-sleeve. I contacted a third surgeon who saw my diagnostic reports. That surgeon agreed with the second opinion surgeon who said my sleeve was started too high up from the pyloris, making for a big antrum and too much volume in my sleeve to reach my goal without getting a re-sleeve, and that Dr. Swain did me a huge disservice, and that I may have re-gain before reaching my goal. Dr. Swain (and Dr. Reynoso for that matter) are rather chubby looking to me. When I met with Dr. Swain recently, he appeared to have put on about 25-30 more pounds since I saw him in May 2019. Perhaps he has been under a lot of stress. Stress raises cortisol, which causes poor blood sugar modulation, and causes other hormonal changes conducive to weight gain. But — oh wait — Adrenal Fatigue “doesn’t exist” and people only get fat because they are lazy and overeat. In all fairness, there are some UPSIDES to having a big sleeve, such as: • less hair loss • less chance of reflux/GERD/Barrett’s • less chance of gallbladder problems • less loose skin • less dehydration • less Body Dysmorphia Disorder I’m sure Dr. Swain is a nice person (except when his work is questioned...), is an excellent surgeon, and I am thankful that my surgery went well with no complications (although for some reason my blood pressure shot up while under anesthesia and that has never happened to me during surgery before). But if you want a tight sleeve and to reach your goal quickly like other people in America who are getting this surgery, then maybe shop around.

I am 8 months post op from Vertical Sleeve Gastrectomy. I researched the surgery 3-4 years first, met with three other “top” surgeons in The Valley and decided on Dr. Swain. He was knowledgeable, experienced, compassionate, humble and patient. The other surgeons were arrogant, but had no reason to be. Dr. Swain could be arrogant, but he isn’t. My surgery went just about perfectly and I had no complications. The HonorHealth - Shea Bariatric Wing goes above and beyond. DO opt for the in-room facial from the hospital’s Spa staff. Due to a plethora of pre-existing endocrine and hormonal issues, my advanced age, fibromyalgia, and a large incisional umbilical hernia from an appendectomy years ago by a different surgeon/hospital, and my (relatively) low starting weight, I have only lost 60 lbs in 8 months. But I was not able to lose ANY weight before VSG! So I am happy with my progress. I continue to lose, just slowly. Being somewhat of a “turtle,” the good news is I have kept… a lot of my hair, don’t have reflux/GERD, have not had nausea or dehydration requiring I.V. fluids post-op in the ER, have very little sagging skin and still have my gallbladder. I will “get there” though. ?? I disagree with him and his dietitian about some minor CICO views, since I like Keto/Intermittent Fasting, but I realize that few bariatric surgeons are pro-Keto/IF...yet. The medical community is notoriously slow to make changes, especially with something so deeply engrained as CICO. But Dr. Swain is about as cutting edge and professional a bariatric surgeon you are going to see.

Dr. Swain is absolutely incredible, too bad his office staff is horrible. The staff is unreliable and incompetent. Starting with the scheduler, to the receptionist, to the dietitian to the insurance liaison. I've been at this process for the past 6 months and am still waiting for the staff to send requested items to the insurance company. I have left numerous phone calls for staff members to call me back and they accuse me of never leaving a message. They blame each other for the lack collaboration and when that doesn't work, they blame the patient. If it weren't for Dr. Swain, I would have never enrolled in this nightmare.

I was 580 pounds and a value meal from a stroke! He made me feel at ease and did an outstanding job on my weight loss surgery. Zero complications or problems. If I could change anything it would be the practices one size fits all approach to aftercare and post op support. I lost 80 pounds before surgery and 140 in the 7 months since I got my sleeve.

Dr. Swainis the best. Very personable, and his team leaves nothing to question. The key eye for detailed understandable information is what sold me to go with Dr. Swain. Even though my insurance did not cover the procedure, it was the best investment I made in myself.

I had a difficult revision surgery to remove an eroded mesh. Dr. Swain was able to make a quick and necessary decision after seeing that the surgery was more difficult that it showed in the pre-op tests. He was at the hospital every day after surgery to make sure I was OK, even on weekends. I am doing wonderful thanks to his care and his staff support.

This man and his staff saved my husband life. I am ever so grateful for this man. Words can't say enough

Awesome, thorough, informative.

Dr. Swain is the FIRST doctor that I felt like really listened to me, and so much so, I asked him if I could give him a hug. I know it sounds cheesy, but if you knew me, you'd know that giving hugs to random strangers, especially a physician, is definitely outside of the norm for me. I would absolutely recommend him!

Dr. Swain in the most compassionate and thorough surgeon and doctor that I've ever been to. He is really personable, extremely good at his job, and understands the many facets of obesity. I can honestly say that I know Dr. Swain cares about me as a person, and is vested in my overall health. I am 6 months post op from the VSG, and attribute my successful weight loss to all of the education and tools that were given to me by Dr. Swain and his staff. If you are struggling with obesity, I'd encourage you to go through a consultation with him. From the very first conversation I had with him, I felt completely at ease and knew that I was in good hands. I have been extremely impressed, and have nothing but good things to say about Dr. Swain.